ArticleFrontiers in public health2026
Relative humidity, precipitation, and outpatient visits for clinically diagnosed fungal otitis externa: evidence from a single-center time-series study in Wuxi, eastern China.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Fungal otitis externa is generally regarded as more common in warm and humid environments, yet long-term daily time-series evidence on short-term associations with meteorological conditions remains limited. Objective: To examine short-term associations between daily meteorological factors and outpatient visits for clinically diagnosed fungal otitis externa, with particular attention to non-linear and lagged patterns. Methods: This single-center retrospective time-series study used outpatient registry data from Wuxi Huishan District People's Hospital in eastern China, covering January 1, 2014, to December 31, 2025. Daily outpatient visits were linked to meteorological data obtained from Open-Meteo. Candidate meteorological variables were screened using single-exposure generalized additive models, and the main associations were evaluated using distributed lag non-linear models within a quasi-Poisson framework, with adjustment for long-term temporal trend and weekday effects. Cumulative relative risks (RRs) and 95% confidence intervals (CIs) were estimated using the median exposure level as the reference. Collinearity among exposures was assessed using Spearman correlation. Results: A total of 6,260 outpatient visits were identified over 4,383 observation days, with a mean daily count of 1.43 visits. Visits were concentrated from July to October. In the main models, relative humidity and precipitation showed the most consistent cumulative associations with outpatient visits. Compared with the median level, the cumulative RR for relative humidity was 1.236 (95% CI, 1.052-1.452) at the 90th percentile and 1.253 (95% CI, 1.038-1.514) at the 95th percentile. The corresponding cumulative RRs for precipitation were 1.087 (95% CI, 1.014-1.166) and 1.142 (95% CI, 1.022-1.276). These associations were concentrated mainly on lag days 2-5. Exploratory analyses suggested that the precipitation association may partly reflect an overlapping moisture-related environmental signal. Conclusions: Higher relative humidity and precipitation were associated with increased outpatient visits for clinically diagnosed fungal otitis externa. Moisture-related meteorological conditions may help characterize short-term fluctuations in outpatient burden.
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